Annually, over 5000 students opt for medical degrees abroad because of low cost and ease of admission, among other reasons.

It is unusual for medical graduates in india to be embarrassed around their relatives. But Kumar Gaurav, who completed his MBBS in March 2016, had not visited his Bihar hometown in two years. His relatives had once made fun of him because he couldn’t practice despite having a medical degree. And that had stabbed him right in his heart.

Gaurav went to a medical college in Nepal, but graduates from that country can’t practice in India unless they clear the Foreign Medical Graduates Examination (FMGE), a screening test conducted by the Medical Council of India twice a year. This applies to graduates from institutions in other countries as well, such as China, Ukraine, Russia, Bangladesh and the Philippines.

Fresh graduates return to India and join the ranks of those who have been trying to pass the test. It’s a tough life.

Chattarpal Vasisth, who did his MBBS from Ukraine, is now enrolled in a coaching institute in South Delhi to crack the screening test. The 26 year old comes from a small village in Haryana’s Bhiwani, and the first to be a doctor from there. “I could not get admission in government medical colleges. Private colleges charged over Rs.50 lakh. In Ukraine, it cost me less than Rs.20 lakh, including hostel fees,” he says.

Like Gaurav and Vasish, more than 5,000 young men and women opt for medical degrees abroad every year because of low cost and ease of admission, among other reasons. China is the most popular destination, followed by Russia, Ukraine, Nepal, Kazakhstan and Bangladesh. Some even go to Pakistan.

The life that follows their return to India is different from what most anticipate. They also have to deal with realisation that, heirarchically, they are considered less meritorious than home-grown medical graduates.

Gautam Nagar, a residential area near AIIMS in Delhi, is known for the large number of medical graduates and aspiring students who live there. Just behind AIIMS are the winding lanes of Gurjar Diary, an unauthorsied colony where hundreds of medical graduates from abroad live in dingy accommodations on a shoestring budget, while enrolled in coaching classes and dreaming of cracking FMGE.

“When I went to study in Ukraine, I assumed I would be more sought after here on my return. Life was tough there. I lived on a tight budget and worked at restaurants,” says Dr Saurav Awasthi, an MBBS now employed at a government hospital in Delhi.

“People think we did not have the merit to study medicine but partied an came back with easy degrees. This is not true. Education standards there are better than most private medical colleges in India and even some government ones,” Awasthi adds. He is now a leading member of All India Foregin Medical Graduates Association, which works for the rights of students like him.

Their image is not enhanced by the fact that graduate from abroad perform poorly in GMGE. Between 2012 and 2014, graduates from Bangladesh performed the best, with 31% clearing the test. Then there are countries like Armenia and Kyrgyzstan, from where only 18% graduates make the cut. Each year, more than 10000 appear for FMGE. In the June 2014 exam, only 5% passed. In June this year, the figure was slightly more encouraging: 26%.

Awasthi and others say the government should make the test compulsory for all graduates, including those from Indian colleges. Dr Yatish Aggarwal, an advisor to the National Board of Examination that conducts FMGE, points out, ” A few years ago, following protests by foreign graduates over low pass percentage in FMGE, we asked some final-year students from Maulana Azad Medical College and Vardhman Mahavir Medical College to take the test without prior notice. Nearly 80% of them qualified. Less than 20% of the foreign graduates made it.”

Recently, the health ministry issued directions that any Indian candidate wishing to pursue medical education from any foreign destination will have to pass the National Eligibility-cum-Entrance Test from now on.

Foreign medical graduates say there is a deep vein of prejudice against them even after acing FMGE. “We get paid lower salaries than domestic graduates. We are deployed on emergency, night shifts or as assistants to senior doctors. To earn respect, we have to get a PG degree. It’s a constant struggle,” says a doctor on condition of anonymity.

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